Prostate Biopsy Increases Risk of Hospitalization

Men who underwent prostate biopsy were more than twice as likely to be hospitalized within 30 days compared with men who did not undergo the procedure, according to a new study.

Researchers at Johns Hopkins University (JHU; Baltimore, MD, USA) analyzed a 5% random sample of Medicare-linked data from the US National Cancer Institute (NCI; Bethesda, MD, USA) Surveillance, Epidemiology, and End Results (SEER) program. The analysis included 17,472 men who underwent prostate biopsy from 1991 to 2007, and a random-sample control group of men who did not have the procedure. The biopsy group was slightly older (median age 73 versus 72.4), healthier, and more likely to be white. The biopsies led to prostate cancer diagnoses in 2,992 men.

The researchers found that prostate biopsy was associated with a 30-day hospitalization odds ratio of 2.65; a total of 1,209 men in the biopsy group were hospitalized within 30 days of the procedure, and for every year of the study period, hospitalization occurred more often than in the control group. Infection was the primary diagnosis in 0.38% of the biopsy group and 0.19% of the control group. Noninfectious complications also led to hospitalization significantly more often after prostate biopsy (0.30%) than in the control group (0.04%). Infectious complications leading to hospitalization rose steadily from 2000 to the end of the study period, possibly a reflection of emerging multidrug-resistant organisms. Significantly, hospitalization for biopsy-related infection increased the mortality odds 12-fold, as compared with men who did not have prostate biopsies. The study was published in the October 2011 issue of the Journal of Urology.

“Prostate biopsy is an essential procedure for detecting prostate cancers; coupled with appropriate screening, prostate biopsies save lives,” said senior author Edward Schaeffer, MD, PhD. “However, it is important for men to be aware of the possible risks of prostate biopsies, which are often described as simple outpatient procedures.”

Since prostate needle biopsy is performed with transrectal ultrasound guidance, the procedure may introduce rectal bacteria into the prostate, creating a potential for infection. Severe infection can lead to hospitalization, as can other potential complications of prostate biopsy, such as hematuria, hematochezia, and urinary retention. To decrease the risk of infection, periprocedural antibiotic prophylaxis has become routine, which unfortunately has the potential to contribute to emerging antibacterial resistance.

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